Guest Blogger

What Would King Solomon Do?

Filed By Guest Blogger | February 23, 2009 10:00 AM | comments

Filed in: Marriage Equality, Politics
Tags: APA, David Blankenhorn, gay marriage, Jack Drescher, marriage equality, New Jersey, Rauch, same-sex marriage

Editors' Note: Guest blogger Jack Drescher, M.D. is a psychiatrist and psychoanalyst in private practice in New York City. He is a Distinguished Fellow of the American Psychiatric Association, and presently serves as a Consultant to APA's Committee on Public Affairs. DrescherColor.jpgHe is a member of the DSM-V Workgroup on Sexual and Gender Identity Disorders. He is the author of Psychoanalytic Therapy and the Gay Man (The Analytic Press) and has edited twenty books dealing with gender, sexuality and the health and mental health of LGBT communities.

A recent New York Times op-ed by David Blankenhorn and Jonathan Rauch, usually on opposing sides of the marriage equality debate, suggests a compromise solution to one of the most contentious social issues of our time:

They write, "Congress would bestow the status of federal civil unions on same-sex marriages and civil unions granted at the state level, thereby conferring upon them most or all of the federal benefits and rights of marriage. But there would be a condition: Washington would recognize only those unions licensed in states with robust religious-conscience exceptions, which provide that religious organizations need not recognize same-sex unions against their will. The federal government would also enact religious-conscience protections of its own. All of these changes would be enacted in the same bill."

The LGBT community's mixed reactions to this "modest proposal" brings to mind a story of King Solomon, once asked to resolve the issue of maternity between two women claiming the same child. "Cut the baby in two and give each woman a half," was his solution. The real mother objected and asked to spare the child and give it to the other woman. Solomon acknowledged her as the true mother and gave her custody of the child.

It is not clear today who in the LGBT community is the "true mother" of the marriage equality movement. Those who advocate for full equality and insist on going without any protections at all until they get all its benefits, or those who think half a baby is better than none?

I favor an incremental approach based on events following a historical watershed in gay civil rights: the 1973 removal of homosexuality from the American Psychiatric Association's diagnostic manual, the DSM.

At the time, the APA decision was highly contentious, pitting psychiatrists of different theoretical persuasions against each other. When the dust cleared, homosexuality was out, although not entirely. In its place stood a diagnosis first called "sexual orientation disturbance" and later renamed as "ego-dystonic homosexuality" (EDH).

EDH was APA's Solomonic compromise to keep the organization intact. It meant that only homosexuals unhappy about their sexuality were mentally ill and provided cover (and insurance reimbursement) to psychiatrists who would still "treat" their gay patients for "homosexuality. " The rest of us gay folks were perfectly fine, thank you very much.

Frank Kameny, a gay activist who played a pivotal role in the APA decision of 1973, had no objection to the new category. He thought anyone distressed at being homosexual was "clearly crazy and in need of treatment by a gay counselor to get rid of societally induced homophobia."

Yet, by 1987, with little resistance from within APA, ego dystonic homosexuality was also taken out of a revised DSM. Why was there no battle this time around?

The EDH compromise made it possible for LGB psychiatrists to come out and openly participate in the APA. Their straight colleagues got to know them and to hear, understand and respect their points of view. The political conditions necessitating a compromise in 1973 no longer existed and in a gay-friendlier APA, no one objected when it was pointed out that unhappiness about one's homosexuality is hardly grounds for calling someone mentally ill.

Despite its imperfections, a federal compromise on marriage along the lines suggested by Blankenhorn and Rauch could go a long way in changing the straight public's perception of gay people. It would make it safer for more gay people to come out. Although it would not change attitudes overnight, it would inevitably lead to change. Perhaps not fast enough for some people, but soon enough for me.

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What would Solomon do? He'd offer to split the baby - just as Blankenhorn and Rauch have done.

The compromise itself isn't the problem for me. The exclusion for religious organizations is a non-starter. To say that churches don't have to perform or recognize unions is one thing, but religious organizations is a concept that is too far reaching.

What would happen were I to be transported by ambulance to the emergency department of a Catholic hospital? Would the hospital staff be free to ignore my partner? With more and more social safety net programs being contracted out to faith based organizations the potential for faith based discrimination is real.

Alternatively, write the exclusion into law along with a proviso that institutions availing themselves of the exclusion would be ineligible to receive federal funds under any federally funded program to include block grants or formula funding.

Upon seeing your short bio, including "presently serves as a Consultant to APA's Committee on Public Affairs. He is a member of the DSM-V Workgroup on Sexual and Gender Identity Disorders," I became quite hopeful to hear any information regarding your workgroup.

This is a very interesting analysis of compromise, but I'd like to ask you if you'd be willing to write any update about the Sexual and Gender Identity Disorders workgroup that would be appropriate at this time. I know many of us are sitting on the edge of our seats, concerned that the DSM might be set up in a way that will be used to endorse or legitimize reparative therapy for trans people -- or the solomonic compromise of reparative therapy for trans and gender variant children.

This is one of those so-called compromise solutions that seems good when you're sitting around the table chatting (or sitting in front of a computer screen jointly writing an op-ed piece), but is a disaster in the real world where such a thing needs to be implemented.

One place to look is New Jersey, which has demonstrated with a lot of real world evidence that the concept of a separate-but-equal civil union does not work. No one recognizes it or adopts it. We still need expensive health care proxy documents and legal fights to get the thing recognized by companies, hospitals, schools, etc.. It's a huge problem on a practical level (aside from the moral problem of a separate status).

I don't think the case of the APA's categorization of homosexuality is a fitting comparison here. In essence, what seemed like a compromise in that case to insiders in the psychiatric field, was actually an all out victory in the eyes of our community and the general public. It was unambiguous. Homosexuality was no longer categorized as a disorder that one had to be cured of. Yes, if someone was really disturbed about their gayness, they could be diagnosed, but so what for the growing number of people who accepted themselves. The message there was "gay people are normal, no different than anyone else."

What is the message of the op-ed compromise on marriage? It's that same-sex couples are "other," not the same as everyone else, because in order to get their legal rights, they must enroll in a separate, new-to-everyone, not-known-by-anyone status.

Unfortunately, when it comes to this issue, there are just no short cuts.

I'm with Greg - the religious exemption is no compromise. It's an expansion of the power of religious orgs to decide what rules they want to follow, which is a clear regression.

The compromise was on civil unions. The religious exemption is just caving into the extreme right.

Marriage is likely one of the largest source of income and continuity for most cults. That’s why they defend it tooth and nail from innovation. The truth is however that partnering predates these cults by ten so thousands of years. Marriage does not belong to the cults. It changes and mutates as the societies around it grow and die.

The American and French Revolutions established marriage as a civil affair. The industrial revolution began to free up women and children from patriarchal dominion. The civil rights movement and immigrants from all over the world, having beaten back racist opposition to the right to marry people of another culture are now happily creating a boisterous and vigorous mix of genes and cultures unseen since the late Roman Empire.

The proposal by Blankenhorn and Rauch is just a reworking of the same bigotry championed by both the Democrat and Republican parties in DOMA and the 'civil unions’ concept. Separate is never equal, no matter what Bush, der Pope, Warren, Obama or the Clintons say. This proposal has nothing to offer but bigotry codified into law, like DADT.

Blankenhorn, like the majority of Democrat liberals in Congress and the White house opposes our right to marriage. They're bigots.

It may well be that we’ll win the fight for same sex marriage rights but the future evolution of partnering and parenting will likely have to wait until we fundamentally change the current government, which is for now an anti-democratic government of the rich, by the rich and for the rich.

He makes an excellent point though, not in the style of King Solomon, but in the vein of which side shoud the GLBT community put their efforts into, incremental change with immediate benefits working towards a larger goal, or its all or nothing. My thoughts are that any benefit seems to be improvement, and as long as it is not seen as defeat but rather progress, I would agree with his analysis.

On the other topic of mental health, I would be very cuious like an earlier commenter, Tobi, to have some insight as to how the sexual identity issues are going to be treated, and if really they just will be falling into more general depression, or relationship issues having to do with unacceptance, rather than personal satisfaction.

Robert Ganshorn Robert Ganshorn | February 23, 2009 10:04 PM

As I addressed college classes in psychology during the debate to change the APA designation I would fall strongly on the side of incremental change. I would appreciate a scenario where the more people got to know people the less bigoted they became.

As regards hospitals. If they want federal funding, and they all do, they will fall into line. Federal law is the "holy grail" that we would be collective fools to ignore.

Thank you for your clear insights Dr. Dresher and give my regards to Fran! :)

If you listen to what the AFA, FotF, FRC, have been saying lately you know that any acceptance by any governmental unit in any way (civil unions, hate-crimes law, partner benefits) is not in their plans. They consider any such "compromise" to be against their moral code and would only lead to the further full equality of marriage for gay peoples. I guess looking at the history of the APA with EDH and finally removing it, they are right.